Provider Demographics
NPI:1114577475
Name:FLOWERS, LETINA MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:LETINA
Middle Name:MICHELLE
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 CROWN WHEEL CIR
Mailing Address - Street 2:
Mailing Address - City:FRUIT COVE
Mailing Address - State:FL
Mailing Address - Zip Code:32259-8216
Mailing Address - Country:US
Mailing Address - Phone:904-994-6030
Mailing Address - Fax:
Practice Address - Street 1:211 CROWN WHEEL CIR
Practice Address - Street 2:
Practice Address - City:FRUIT COVE
Practice Address - State:FL
Practice Address - Zip Code:32259-8216
Practice Address - Country:US
Practice Address - Phone:904-994-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001254363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner